Helical Cartilage Inversion and V-Y Advancement Flap for Type IIB Constricted Ear Correction.

OBJECTIVES

A type IIB constricted ear is a common congenital auricular deformity. Traditional methods often require multistage surgeries or contralateral tissue transplantation. We hypothesized that helical cartilage inversion grafting combined with a V-Y advancement flap could achieve effective single-stage correction with comparable morphologic improvements to traditional methods, while significantly eliminating donor-site morbidity. This study aims to evaluate the clinical efficacy and safety of this technique.

METHODS

This retrospective analysis included 20 patients (23 ears) with type IIB constricted ear. Through a retroauricular approach, the excessively folded helical cartilage was transected to create a free cartilage graft, then inverted and reconnected. A retroauricular V-Y advancement flap provided soft tissue coverage. Surgical outcomes were assessed using auricular measurements, the Aesthetic Outcomes Scale (AOS), and the Visual Analog Scale (VAS).

RESULTS

The mean patient age was 5.2±1.8 years with a 12-month follow-up. Postoperative ear vertical height increased from 40.3±3.5 to 50.5±3.8 mm (25.3% increase, P<0.001). AOS scores improved from 1.8±0.6 to 3.2±0.7 (P<0.001). VAS satisfaction scores increased from 2.1±1.2 to 8.3±1.4 (P<0.001). A total of 90% of patients achieved satisfaction scores ≥7, with 13.0% complication rate.

CONCLUSION

Helical cartilage inversion grafting combined with V-Y advancement flap is a safe and effective single-stage correction method for type IIB constricted ear, characterized by minimal trauma, adequate soft tissue coverage, and low complication rates, providing a valuable clinical treatment option.